A clinical case study of long-term injury of the thoracic and lumbar spine

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Abstract

Overestimation of the efficacy of conservative treatment of spine injuries children often leads to unsatisfactory long-term results. The effective correction of post-traumatic spinal column deformities occurs in patients who undergo the operation in the early post-traumatic period. While choosing treatment strategies for children, higher reparative opportunities, which provide early fracture consolidation, including those in faulty positions, should be considered. This study presents a case of surgical treatment for uncomplicated injury of the thoracic and lumbar spine, with long-term compression fragmental fracture of the L1 vertebra body in a 12-year-old child. Due to the long-standing character of the injury right thoraco-frenotomy was conducted with partial L1 vertebral body and resection of the adjacent discs, deformity correction of the thoracic and lumbar spine with a transpedicular system, and ventral spondylodesis with an autograft. This extensive intervention was justified by the peculiarities in the vertebral body damage and the post-traumatic segmental kyphotic deformity that resulted from delayed medical treatment. An anterior approach was chosen to achieve immobilization at the site of the damage before correction using the transpedicular system. Surgical correction of long-term spinal injuries in children, with the use of a combined approach, is usually laborious and traumatic. The prevention of rigid post-traumatic spine deformities with the help of timely diagnostics and appropriate treatment, including surgery, should be a priority to prevent such cases.

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About the authors

Vladimir V Zaretskov

Saratov Scientific and Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: fake@eco-vector.com
MD, PhD, professor, leading research associate. Saratov Scientific and Research Institute of Traumatology and Orthopedics. Russian Federation

Vladislav B Arsenievich

Saratov Scientific and Research Institute of Traumatology and Orthopedics

Email: fake@eco-vector.com
MD, PhD, chief of the department of traumatology and orthopedics No 3. Saratov Scientific and Research Institute of Traumatology and Orthopedics. Russian Federation

Sergey V Likhachev

Saratov Scientific and Research Institute of Traumatology and Orthopedics

Email: Likha4@mail.ru
MD, PhD, orthopedic and trauma surgeon. Saratov Scientific and Research Institute of Traumatology and Orthopedics Russian Federation

Alexey E Shul’ga

Saratov Scientific and Research Institute of Traumatology and Orthopedics

Email: fake@eco-vector.com
MD, PhD, senior research associate. Saratov Scientific and Research Institute of Traumatology and Orthopedics. Russian Federation

Sergey V Stepukhovich

Saratov Scientific and Research Institute of Traumatology and Orthopedics

Email: fake@eco-vector.com
MD, PhD, orthopedic and trauma surgeon. Saratov Scientific and Research Institute of Traumatology and Orthopedics. Russian Federation

Nina V Bogomolova

Saratov Scientific and Research Institute of Traumatology and Orthopedics

Email: fake@eco-vector.com
MD, PhD, professor, corresponding member of RANS, AMS. Saratov Scientific and Research Institute of Traumatology and Orthopedics. Russian Federation

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Copyright (c) 2016 Zaretskov V.V., Arsenievich V.B., Likhachev S.V., Shul’ga A.E., Stepukhovich S.V., Bogomolova N.V.

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